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Oxygen Uptake, Ventilation, and Symptoms During Low-Frequency Versus High-Frequency NMES in COPD: A Pilot Study

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Abstract

Transcutaneous neuromuscular electrical stimulation (NMES) involves the application of an electrical current through electrodes placed on the skin over the targeted muscles. During high-frequency NMES (HF-NMES), oxygen uptake, minute ventilation, and the degree of symptom perception (dyspnea and fatigue) have been shown to be acceptable in chronic obstructive pulmonary disease (COPD). Currently, oxygen uptake and ventilation load have never been assessed during low-frequency NMES (LF-NMES) of the lower-limb muscles. The purpose of this study was to compare prospectively oxygen uptake, ventilation, and symptom perception during a single session of LF-NMES versus a single session of HF-NMES of quadriceps muscles in patients with COPD. In 17 COPD patients (mean FEV1 = 45% predicted, mean body mass index = 26.2 kg/m2), peak exercise capacity, functional exercise capacity, and the Medical Research Council dyspnea grade were evaluated. In addition, oxygen uptake, minute ventilation, heart rate, and Borg symptom scores were assessed during one session of LF-NMES (15 Hz) and one session of HF-NMES (75 Hz) and compared with peak values. Mean oxygen uptake (LF-NMES: 327 ml/min vs. HF-NMES: 315 ml/min), minute ventilation (LF-NMES: 14 L vs. HF-NMES: 15 L), and heart rate (LF-NMES: 86 BPM vs. HF-NMES: 83 BPM) were similar during both NMES frequencies. Patients used a relatively low proportion of their peak aerobic capacity during both NMES sessions (LF-NMES: 34% vs. HF-NMES: 33%; P = 0.397). In addition, symptom Borg scores for dyspnea and leg fatigue were also comparable. Oxygen uptake, ventilation, and symptoms of dyspnea and fatigue were comparable and tolerable during LF-NMES and HF-NMES in patients with COPD. Therefore, LF-NMES and HF-NMES may both be suitable rehabilitative modalities to be used in severely dyspneic patients with lower-limb muscle dysfunction.

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Abbreviations

BMI:

Body mass index

BPM:

Beats per minute

COPD:

Chronic obstructive pulmonary disease

CPET:

Cardiopulmonary exercise test

DLCO :

Diffusion capacity of the lung for carbon monoxide

FEV1 :

Forced expiratory volume in 1 s

FFMI:

Fat-free mass index

HF-NMES:

High-frequency transcutaneous neuromuscular electrical stimulation

IQR:

Interquartile range

LF-NMES:

Low-frequency transcutaneous neuromuscular electrical stimulation

MRC:

Medical Research Council dyspnea scale

MVV:

Maximal voluntary ventilation (MVV = 40*FEV1)

% MVV:

Percentage maximal voluntary ventilation

6MWD:

Distance achieved by the 6-min walking test

NMES:

Transcutaneous neuromuscular electrical stimulation

Peak HR:

Peak heart rate

Peak VE:

Peak minute ventilation (in liters, L)

Peak VO2 :

Peak oxygen uptake (in ml/min)

% pred:

Percentage predicted value

VC max:

Maximum vital capacity

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Acknowledgments

The authors are grateful to the patients who graciously consented to participate in our study. This research was supported by research grants from the Netherlands Asthma Foundation, Leusden, the Netherlands (grant No. 3.4.09.024) and the Weijerhorst Foundation, Maastricht, the Netherlands.

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The authors have no conflicts of interest or financial ties to disclose.

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Correspondence to Maurice J. H. Sillen.

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Sillen, M.J.H., Wouters, E.F.M., Franssen, F.M.E. et al. Oxygen Uptake, Ventilation, and Symptoms During Low-Frequency Versus High-Frequency NMES in COPD: A Pilot Study. Lung 189, 21–26 (2011). https://doi.org/10.1007/s00408-010-9265-0

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  • DOI: https://doi.org/10.1007/s00408-010-9265-0

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